Training docs just part of job at med school; ASU’s osteopaths aiming to make communities healthier

As students wove through the halls of the osteopathic medical school on the Jonesboro campus of Arkansas State University recently, hundreds of dressed-up hopefuls chatted nervously as they waited their turn to interview with the school's admission committee.

Each year, since the state's first osteopathic medical school opened in the fall of 2016, the school sifts thousands of applicants from around the state and nation for the 125 slots that open each fall. Their goal is entry into the New York Institute of Technology College of Osteopathic Medicine campus in Jonesboro.

In an office away from the bustle, Dr. Shane Speights, dean of the college at ASU, pointed outside his door toward the school's auditorium.

"We're trying to find out, 'Is this somebody who might be a good fit for our mission and our vision for what health care should look like?'" Speights said in an interview a few weeks ago. "Historically, it's students from the background that we're trying to address."

Nearly half of the school's more than 350 students come from towns of less than 50,000 people or from impoverished urban areas with high rates of free- and reduced-price lunch programs in their schools. Many are their families' first college graduates.

"The vast number of them have such enduring stories of personal growth and the challenges and obstacles they overcame to get here," Speights said. "I think, just by our mission and by who we are, we attract students with, really, the heart for medicine and the heart for health care and healing. We're very proud of that."

WHAT TO BRING

That experience, that empathy for the underserved, cannot be taught, Speights said.

"The student needs to come with that," Speights said. "We can teach them everything about how to cure and manage disease, but we would like for them to have the servant mindset and the servant leadership aspect already ingrained."

The school's curriculum is specifically designed to facilitate and grow that mindset and to reinforce the mission of osteopathic medicine to treat the whole person in mind, body and spirit, Speights said.

The difference is mostly philosophical between doctors of osteopathic medicine and doctors of medicine.. Both are similarly educated and certified, but doctors of osteopathic medicine receive special training in the musculoskeletal system and complement traditional medicine with an emphasis on patients' lifestyles, while doctors of medicine focus on remedies such as drugs or surgery to treat symptoms.

In the fall of 2018, more than 100 of the school's third-year students went out into the underserved areas of the state and region -- mainly the Delta -- to spend the next two years working side-by-side with rural physicians at private practices as well as hospitals. They were the first class from the school to do so.

The school has a partnership with about 150 facilities, said Casey Pearce, spokesman for the Jonesboro campus of the Osteopathic Medicine College.

"Their fourth year also consists of clinical rotations, some of which will be done in the same city they were in for their third year," Pearce said. "They have an opportunity to choose elective rotations based on their preferred specialty."

STAYING CLOSE

Speights said the clinical rotations also heighten the chances those students will return to the same area to practice after they complete medical school and residencies.

"Some of those students are in those areas for two years. It's not just a one-month rotation," Speights said. "Some of them are actually doing the bulk of their medical education, in terms of the clinical aspect, in those areas. And that's a phenomenal experience."

Third-year medical student Derika Mays echoed that sentiment. Mays was born and raised in Osceola, a Mississippi County town in the Arkansas Delta with a population just under 8,000.

Married with a 5-year-old daughter, Mays is living in Jonesboro while she finishes her education, but is adamant she will return to practice medicine in her hometown.

"There are not a lot of physicians there," Mays said.

Even more so, she said, there are no specialists close to the area, causing patients to drive hours for appointments with doctors such as nephrologists or orthopedists.

"It would be great if we could open more community health centers in these locations," Mays said.

According to the Association of American Medical Colleges, Arkansas ranks 46th in the nation when it comes to physicians per capita, with 203 physicians per 100,000 population. The state ranks 36th in the nation in the number of primary care physicians at 79.5 doctors per 100,000 people.

About 64 percent of the nearly 350 students of the Jonesboro osteopathic medical campus hail from Arkansas towns or bordering states that are considered part of the Mississippi Delta, Pearce said.

"Like in Derika's case -- a student from Osceola is much more likely to practice in a place like Osceola than a student from Dallas is," Pearce said.

Speights, who went to medical school in Kansas City, Mo., after serving as a paramedic on an ambulance route in Arkadelphia, said the school isn't waiting until the students graduate to make an impact on the communities they serve.

"I can be the best doctor there is. I could have the patient sitting in front of me and I can explain to them why it's important for them to take this medication for their blood pressure and go through all the details. But if they get up and walk out the door and never fill that prescription, I'm wasting my time and the patient's wasted theirs," Speights said. "That goes back to health education and that's something our students can start doing right from the beginning."

This spring, students will staff the "Delta Care-a-van," which was obtained through a U.S. Department of Agriculture Delta Healthcare Services grant. The mobile medical unit will dispense health screenings, health education and preventive care.

"We expect them to speak to local civics groups, the Rotary Club, the Lions Club, talking about vaccinations, or immunizations or talking about the obesity rate in Arkansas or dental care," Speights said. "Whatever it may be, we expect our students to be providing information."

The medical school is also working to increase the state's residency opportunities -- the postgraduate education required to obtain licenses. Speights helped to start an internal residency program at St. Bernards Regional Medical Center in Jonesboro as well as at other hospitals and facilities in the state.

There has long been a shortage of residency spots, both for medical and osteopathic doctors, in the nation. According to the National Resident Matching Program, about 44,000 doctors vie for just 33,000 open residency slots each year.

Currently, the osteopathic residencies match program is separate from those of traditional medical schools -- including the state's only such school, the University of Arkansas for Medical Sciences. By 2020, a single accreditation system will be formed when the American Osteopathic Association and the American Association of Colleges of Osteopathic Medicine merge with the medical doctors' program, the Accreditation Council for Graduate Medical Education.

"We are intimately involved with the expansion of residency programs in the state, which is, again, another ingredient in the recipe to try to fill the workforce needs in Arkansas," Speights said.

In the future, Speights said, the school hopes to create more pipeline programs to guide students in the K-12 school system towards medical careers. The school sponsors a four-day overnight camp for high school students to learn about community health care. The school's medical students act as camp counselors.

Speights also envisions the third-year students reaching out to schools in the communities they serve to talk about prevention, such as the importance of handwashing or of getting the flu vaccine.

"All of these things, that certainly we in the medical profession take for granted as common knowledge, we should be passing on. And our students don't have to be graduates to do that," Speights said. "We feel that graduating excellent physicians is only one part of our responsibility as a medical school."

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